AccountId: 011433970860
ContactId: 36e80038-193c-4fc6-b6e7-b5081dce39de
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 243240 ms
Total Talk Time (AGENT): 122284 ms
Total Talk Time (CUSTOMER): 91805 ms
Interruptions: 1
Overall Sentiment: AGENT=0.7, CUSTOMER=-0.2
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/01/06/36e80038-193c-4fc6-b6e7-b5081dce39de_20250106T15:49_UTC.wav
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[AGENT][POSITIVE] Good afternoon. I'm sorry, good morning. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi, good morning, my name is [PII]. I'm calling to check benefit for the patient, please.
[AGENT][POSITIVE] Thank you, [PII]. It would be my pleasure to help you with, [PII]. uh, I'm sorry with benefits this morning. What is the, what is a good callback number, [PII]?
[CUSTOMER][NEUTRAL] No.
[CUSTOMER][NEUTRAL] Hi, it's uh [PII].
[AGENT][NEUTRAL] Thank you, [PII], and the policy number for the patient, please?
[CUSTOMER][NEUTRAL] I got here 018491 88 M as in Mary L 8.
[AGENT][NEUTRAL] Thank you. And the patient's name and date of birth?
[CUSTOMER][NEUTRAL] The patient name, last name is [PII], first name is [PII], [PII].
[AGENT][POSITIVE] All right, thank you. And it'd be my pleasure to assist you with that eligibility.
[AGENT][NEGATIVE] Now, I'm actually showing that that policy is no longer active.
[CUSTOMER][NEUTRAL] At this
[AGENT][NEUTRAL] Yes, she does have active coverage under another policy number. Can I give you the correct policy number?
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Please.
[AGENT][NEUTRAL] As of [PII], her active policy number is 246.
[CUSTOMER][NEUTRAL] Mm.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] 768 5.
[AGENT][NEUTRAL] And we also have her listed as [PII].
[CUSTOMER][NEUTRAL] Mm, OK, yeah we have it here.
[AGENT][NEUTRAL] So it's double last name.
[CUSTOMER][NEUTRAL] OK, we have a son [PII].
[AGENT][NEUTRAL] Yeah. Yeah, and the last name [PII].
[CUSTOMER][NEUTRAL] OK, let me put it here the new.
[CUSTOMER][NEUTRAL] Member.
[CUSTOMER][NEUTRAL] Mhm.
[CUSTOMER][NEUTRAL] Mm.
[AGENT][NEUTRAL] And this is a secondary policy to her major medical coverage, yeah.
[CUSTOMER][NEUTRAL] Yes.
[AGENT][NEUTRAL] Anything else I can help you with?
[CUSTOMER][NEUTRAL] Uh, can, uh, you be able to provide me the benefits for this, uh, patient, or no?
[AGENT][NEUTRAL] I can. I certainly can. What type of coverage are you needing?
[CUSTOMER][NEUTRAL] Um, this is a specialist office visit and I'm calling to check if she has, um, um, under this uh secondary insurance she cover co-payment to the office, uh, copayment or the procedure done in the office, uh, the inpatient case that she has inpatient benefit also.
[AGENT][NEUTRAL] Well, I can help you with those benefits. Now, for the visit, it would not be covered.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] She does have treatment in office.
[AGENT][NEUTRAL] Um, benefit
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] And, and she has inpatient. For the inpatient hospital, that benefit amount is $8500 per calendar year.
[CUSTOMER][NEUTRAL] Yes.
[CUSTOMER][NEUTRAL] Mhm.
[AGENT][NEUTRAL] And for outpatients, she has 8500 per calendar year. That would cover the treatment in office.
[CUSTOMER][NEUTRAL] The dreamer at the office, OK, and can you provide me a reference number please for this call if you don't mind.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Reference number yeah it reference number is my name and today's date.
[AGENT][NEUTRAL] And
[AGENT][NEUTRAL] I spell my name [PII]. If you'd also please note all benefits given over the phone is a verification of coverage and not a guarantee of payment.
[AGENT][NEUTRAL] Anything else I can help you with, [PII]?
[CUSTOMER][NEUTRAL] Oh OK.
[CUSTOMER][NEGATIVE] No thank you.
[AGENT][POSITIVE] And thank you for calling APL. I hope you have a wonderful day.
[CUSTOMER][NEUTRAL] You too, bye.
[AGENT][NEUTRAL] Bye bye.